Seroprevalence against Toscana virus in Spain: The case of the autonomous community of Madrid.

BACKGROUND & OBJECTIVES: The Toscana virus (TOSV) is a neurotropic arbovirus that is transmitted through the bite of some Phlebotomus species. In 2009, the largest outbreak of leishmaniasis described so far in Europe, occurred in the Autonomous Community of Madrid, Spain, which was related to the population increase of P. perniciosus in this region. METHODS: A seroprevalence study was conducted to determine the circulation of TOSV among the population of this geographic area. A total of 516 sera were collected in two different stages: 2007 (before the leishmaniasis outbreak) and 2018-19 (representative of the current situation). In the sera, presence of IgG antibodies against TOSV was determined by commercial ELISA. RESULTS: The overall seroprevalence was 34.5%. The anti-TOSV IgG level was significantly higher in the samples collected in 2007 (41.5%) than 2018-19 (27.3%). INTERPRETATION & CONCLUSION: The results of this study show a very active TOSV circulation in the region that is greater than expected. The lower seroprevalence figures in 2018-19 may be related to the vector and environmental control measures that were put in place as a result of the leishmaniasis outbreak of 2009. This highlights the importance of such strategies to reduce the incidence of TOSV infection and other vector-borne diseases.

Design of New Procedures for Diagnosing Prevalent Diseases Using a Low-Cost Telemicroscopy System.

BACKGROUND: Currently, the diagnosis of prevalent diseases such as malaria, tuberculosis, or diarrheal diseases in rural areas of developing countries requires the displacement of the patient from their community health post to their reference health center or to ship a sample. This delays diagnosis and the treatment of disease. OBJECTIVE: Conduct research to develop a new method for rapid low-cost diagnosis of prevalent diseases in rural areas of developing countries (malaria, tuberculosis, parasitic infections, vaginal infections, and cervical cancer). METHODS: The study was divided into three phases. The first related to the drafting and validating of new protocols for the preparation of samples that should be adapted to be carried out in areas without power and with little trained personnel. The second phase consisted of developing a telemicroscopy system looking for low cost, software compatibility, and technical quality. Finally, the third phase evaluated the system as a diagnostic tool using direct observation with a conventional microscope as the gold standard. RESULTS: The validation of the new protocols showed that 100% of the vaginal swabs were processed correctly when using direct smear, while they were only 86.3% correct when using Gram stain; 68.3% of fecal samples were correctly processed using Kinyoun stain; 61.7% of blood samples when using thin film; and 83.8% when using thick film. Phase 2 permitted the development of a low-cost (<$250) and low-power (<15 W) telemicroscopy system that allows real-time consultation between health technicians and specialists. Finally, phase 3 proved that there was no difference between the diagnostics obtained by direct observation in a microscope and those ones obtained through the new telemicroscopy system. CONCLUSIONS: This study has verified the effectiveness of the telemicroscopy system as a diagnostic tool, given the complete agreement between the diagnoses made with it and those made with the gold standard.

[The effect of Clostridium difficile infection on length of hospital stay. A cohort study]. / Efecto de la infección por Clostridium difficile sobre la estancia hospitalaria. Estudio de cohortes.

INTRODUCTION: Clostridium difficile is responsible for a spectrum of diseases known as "Clostridium difficile infection" (CDI). It is currently the leading cause of nosocomial diarrhea in developed countries. This infection has been associated with both increased hospital stay and mortality, and to a greater likelihood of readmission. In our country these undesirable effects have not yet been characterized. Our objective was to quantify the increase in hospital stay attributable to infection by C.difficile. METHODS: A retrospective cohort study matched by age, sex and admission date, was conducted in a tertiary care university hospital during an outbreak of nosocomial transmission of CDI. RESULTS: The cohort study included 38 infected, and 76 non-infected patients. Patients who developed CDI showed a higher proportion of malnutrition at admission (OR=10.3; 3.6 to 29.6), were exposed to a wider range of antibiotics (mean difference=1.5; 0.7-2.2), had a higher mortality (31.6% vs. 6.6% of controls, P<.001), and a longer hospital stay (median 31.5 days versus 5.5 days for controls, P<.001). After adjustment, infection by C.difficile was associated with an increase in hospital stay of 4 days (P<.001). CONCLUSIONS: C.difficile infection has important consequences on the length of hospital stay, and therefore on health costs.

Detection of Mycobacterial DNA in Human Bone Marrow.

Bone marrow is a cell-rich tissue of the reticuloendothelial system essential in the homeostasis and accurate functioning of hematopoiesis and of the immune system; moreover, it is also rich in lipids because it contains marrow adipocytes. This work aimed to evaluate the detection of mycobacterial DNA in human bone marrow as a tool to understand the complex pathology caused by the main pathogen Mycobacterium tuberculosis (Mtb). Formalin-fixed paraffin-embedded human bone marrow samples were studied using both conventional PCR + hybridization and in situ PCR to figure out the cell distribution of the targeted DNA. Samples were retrospectively collected from HIV+ patients with microbiologically proved mycobacterial infection and from subjects without evidence of infection. Mycobacterium avium (Mav) as well as Mtb DNA was detected in both settings, including tissues with and without granulomas. We detected DNA from both mycobacterial species, using in situ PCR, inside bone marrow macrophages. Other cell types, including adipocytes, showed positive signals only for Mtb DNA. This result suggested, for the first time, that marrow adipocytes could constitute an ideal reservoir for the persistence of Mtb, allowing the bacilli to establish long-lasting latent infection within a suitable lipid environment. This fact might differentiate pathogenic behavior of non-specialized pathogens such as Mav from that of specialized pathogens such as Mtb.

[Epidemiology of community-acquired rotavirus gastroenteritis in Fuenlabrada (Madrid)]. / Epidemiología de la gastroenteritis por rotavirus adquirida en la comunidad en el área de Fuenlabrada (Madrid).

INTRODUCTION: Rotavirus is the main aetiological agent of severe acute gastroenteritis in childhood. MATERIAL AND METHODS: A prospective study on the incidence and cost of acute gastroenteritis in children under 5 years. RESULTS: Rotavirus was the most frequent aetiological agent. The cumulative incidence of hospitalisation decreased over the study period. CONCLUSIONS: Rotavirus is the most common cause of acute community acquired gastroenteritis requiring hospital admission in the area of Fuenlabrada (Madrid).

Paediatric hospitalizations due to whooping cough in Spain (1997-2017).

This epidemiological survey estimates the burden of whooping cough in infants up to 12 months old in Spain during a twenty-one-year period (1997-2017). The survey was conducted by reviewing data from the Spanish Surveillance System for Hospital Data. All hospitalizations due to whooping cough for infants, reported during the 1997-2017 period, were analysed. Codes were selected from the International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes 033.0-033.9. To explore the latest national outbreak and the implementation of vaccination in pregnant women, analyses were stratified to compare the following periods: 1997-2010, 2011-2015 and 2016-2017. A total of 13,352 hospital discharges for whooping cough in infants up to 12 months old were reported. A total of 6850 discharges in the period 1997-2010, 5271 in the period 2011-2015 and 1231 in 2016-2017 were identified. The annual hospitalization rate prior to 2011 was 131.02 cases per 100,000 infants; in 2011-2015, the rate was significantly higher (250.13 cases per 100,000 infants) and in 2016-2017 it decreased (157.69 cases per 100,000 infants). Most of the cases (n = 11,446) occurred in infants under 4 months of age, with hospitalization rates of 328.80, 670.81 and 385.84 cases per 100,000 infants up to 4 months of age in the periods 1997-2010, 2011-2015 and 2016-17, respectively. Thirty-four deaths occurred in the period 1997-2010, 36 in the period 2011-2015 and 4 in 2016-2017. All of the deaths occurred in infants under 4 months old. The case fatality rate did not vary significantly across the study periods. Whooping cough infections concentrate in infants up to 4 months of age in Spain. Public health measures such as vaccination of pregnant women, caregivers, health care professionals and relatives, especially young parents, could reduce the hospitalization burden during the current outbreak.

Respiratory Syncytial Virus Bronchiolitis in Children up to 5 Years of Age in Spain: Epidemiology and Comorbidities: An Observational Study.

This epidemiological survey in Spain estimates the burden of respiratory syncytial virus (RSV) infection in children up to 5 year of age during a 15-year period (1997-2011). Observational retrospective survey was conducted by reviewing data of the National Surveillance System for Hospital Data, including >98% of Spanish hospitals. All hospitalizations related to RSV infection for children up to 5 years, reported during 1997-2011 period, were analyzed. Codes were selected by using the International Classification of Diseases 9th Clinical Modification 466.0-466.19, 480.1, and 079.6. A total of 326,175 and 286,007 hospital discharges for children up to 5 and 2 years of age were reported during the study period. The annual incidence was 1072 and 2413 patients per 100,000, respectively. The average length of hospital stay was 5.7 (standard deviation 8.2) days. Four hundred forty-six deaths were reported; of those, 403 occurred in children <2 years and 355 (80%) occurred in children <12 months of age. Hospitalization and mortality rates were significantly higher in boys and decrease significantly with age. The higher rate of hospitalization and mortality rates were found in the first year of life. Annual average cost for National Health Care System was € 47 M with a mean hospitalization cost of €2162. The average length of hospitalization and costs were significantly higher in high-risk children. RSV infections in children up to 5 year of age still pose a significant health threat in Spain, especially in the infants. The development of preventive, diagnostic, and therapeutic guidelines focused in children with comorbidities may help reduce the hospital and economic burden of the disease.

Shrinking the Lymphatic Filariasis Map of Ethiopia: Reassessing the Population at Risk through Nationwide Mapping.

BACKGROUND: Mapping of lymphatic filariasis (LF) is essential for the delineation of endemic implementation units and determining the population at risk that will be targeted for mass drug administration (MDA). Prior to the current study, only 116 of the 832 woredas (districts) in Ethiopia had been mapped for LF. The aim of this study was to perform a nationwide mapping exercise to determine the number of people that should be targeted for MDA in 2016 when national coverage was anticipated. METHODOLOGY/PRINCIPAL FINDING: A two-stage cluster purposive sampling was used to conduct a community-based cross-sectional survey for an integrated mapping of LF and podoconiosis, in seven regional states and two city administrations. Two communities in each woreda were purposely selected using the World Health Organization (WHO) mapping strategy for LF based on sampling 100 individuals per community and two purposely selected communities per woreda. Overall, 130 166 people were examined in 1315 communities in 658 woredas. In total, 140 people were found to be positive for circulating LF antigen by immunochromatographic card test (ICT) in 89 communities. Based on WHO guidelines, 75 of the 658 woredas surveyed in the nine regions were found to be endemic for LF with a 2016 projected population of 9 267 410 residing in areas of active disease transmission. Combining these results with other data it is estimated that 11 580 010 people in 112 woredas will be exposed to infection in 2016. CONCLUSIONS: We have conducted nationwide mapping of LF in Ethiopia and demonstrated that the number of people living in LF endemic areas is 60% lower than current estimates. We also showed that integrated mapping of multiple NTDs is feasible and cost effective and if properly planned, can be quickly achieved at national scale.

Different vaccination strategies in Spain and its impact on severe varicella and zoster.

Varicella vaccines available in Spain were marketed in 1998 and 2003 for non-routine use. Since 2006 some regions decided to include varicella vaccination in their regional routine vaccination programmes at 15-18 months of age. Other regions chose the strategy of vaccinating susceptible adolescents. This study shows the trends in severe varicella zoster virus infections through the analysis of the hospital discharges related to varicella and herpes zoster in the general population from 2005 to 2010 in Spain. A total of 11,125 hospital discharges related to varicella and 27,736 related to herpes zoster were reported during the study period. The overall annual rate of hospitalization was 4.14 cases per 100,000 for varicella and 10.33 cases per 100,000 for herpes zoster. In children younger than 5 years old varicella hospitalization rate significantly decreased from 46.77 in 2005 to 26.55 per 100,000 in 2010. The hospitalization rate related to herpes zoster slightly increased from 9.71 in 2005 to 10.90 per 100,000 in 2010. This increase was mainly due to the significant increase occurring in the >84 age group, from 69.55 to 97.68 per 100,000. When gathering for regions taking into account varicella vaccine strategy, varicella related hospitalizations decreased significantly more in those regions which included the vaccine at 15-18 months of age as a routine vaccine comparing with those vaccinating at 10-14 years old. No significant differences were found in herpes zoster hospitalization rates regarding the varicella vaccination strategy among regions. Severe varicella infections decreased after implementation of varicella vaccination in Spain. This decrease was significantly higher in regions including the vaccine at 15-18 months of age compared with those vaccinating susceptible adolescents.

Impact of non-routine rotavirus vaccination on hospitalizations for diarrhoea and rotavirus infections in Spain.

This study shows hospital discharges related to all-cause diarrhoea and rotavirus infection in children up to five years of age from 2005 to 2009 in Spain. Rotavirus vaccines have been available in Spain since late 2006 and early 2007. They are neither funded nor reimbursed by the National Health Care System. However, they are recommended by the Spanish Association of Pediatricians and prescribed by paediatricians. The vaccination coverage was 17% in 2007, 35% in 2008 and 38% in 2009. Among a total of 111,738 hospitalizations recorded, 24% (N=26,500) were coded as rotavirus and 14% (N=16,217) as diarrhoea of undetermined aetiology. The overall annual incidence of hospitalization was 991,235 and 144 per 100,000 children up to five years of age for all-causes diarrhoea, rotavirus infection and diarrhoea of undetermined aetiology respectively. The annual rate significantly decreased during the study period. Hospitalization rates for all-cause diarrhoea, rotavirus infection and diarrhoea of undetermined aetiology in children under five years of age in 2009 were 35, 37 and 36% lower than in the period 2005-2006, before rotavirus vaccine introduction. This decrease was greater in children <12 months of age: 42% for all-cause diarrhoea and 43% for rotavirus and diarrhoea of undetermined aetiology. The use of rotavirus vaccines, with relatively low vaccination coverage, in Spain has been shown to decrease hospitalizations for rotavirus gastroenteritis and all-cause diarrhoea during the study period.

Seroprevalence of antibodies against measles, rubella, mumps, varicella-zoster, and B. Pertussis in young adults of Madrid, Spain.

In recent years, there has been an increase in the number of cases of certain immunopreventable diseases in our country. A high proportion of these have been recorded among the young adult population. The aim of this study was to determine the seroprevalence of antibodies against immunopreventable diseases with the greatest health impacts on the young adult population (19-39 y of age) in Madrid. We collected a total of 1,153 serum samples from healthy volunteers undergoing routine medical visits and used ELISA to determine the presence of IgG antibodies against measles, rubella, mumps, and varicella zoster, as well as Bordetella pertussis. The Pearson's χ(2) test was used to compare prevalences, the Mann-Whitney U test was used to compare means, and the Kruskal-Wallis test was applied for variables with more than 2 categories. Statistical significance was achieved with p values of<0.05. The global prevalence of antibodies was 92.1% for measles, 94.4% for rubella, 88.3% for mumps, 92.8% for varicella zoster, and 70.2% for B. pertussis. No statistically significant differences were found between genders. The prevalence of antibodies against measles was more than 95% in the group of individuals born after 1986, and the percentage of individuals susceptible to rubella was less than 5% in women born after 1986. In spite of adequate vaccination coverage, in our region, a population of young adults exists who have not achieved the objectives of the WHO for the elimination of measles and congenital rubella syndrome.

Epidemiology of gonorrhoea-related hospitalisations in Spain between 1997 and 2006.

OBJECTIVE: The prevalence of gonorrhoea has increased worldwide in the last few years. Gonorrhoea is one of the most common sexually transmitted infections (STIs) in the world, and is a serious public health problem because of its associated morbidity and complications. The objective of this study was to estimate the frequency of gonorrhoea-related hospitalisations in Spain between the years 1997 and 2006. STUDY DESIGN: A retrospective epidemiological study was conducted using data from the National Epidemiological Surveillance System (Minimum Data Set [MDS]), where all of the gonorrhoea-related hospitalisations that occurred in Spain during this period were analysed. We calculated the general hospitalisation rates, mortality, case-fatality rate, and length of stay by gender and age. RESULTS: During the course of the study, 928 hospitalisations occurred with a discharge diagnosis of gonorrhoea infection (International Classification of Diseases, 9th Revision, Clinical Modification: ICD 9 CM 098.0-098.89 at any diagnostic position), which represented a hospitalisation rate of 0.23 per 100,000 population, a mortality rate of 0.008 per 100,000 population, and a case-fatality of 3.77%. The main suspected causes of death were staphylococcal and streptococcal infections, malignant neoplasm and chronic diseases. The greatest hospitalisation rate was observed in children between the ages of 0 and 4years. CONCLUSIONS: The gonorrhoea-related hospitalisation rate in Spain remained constant during the period of the study. A better understanding of the epidemiology of gonorrhoea will allow for the creation of effective preventive measures that will lead to a reduction in the number of new infections.

The burden of hospitalizations for meningococcal infection in Spain (1997-2008).

All hospital discharges and deaths related to invasive meningococcal disease, meningococcal meningitis and meningococcemia in the general population from 1997 to 2008 in Spain were obtained. Among the 11,611 meningococcal infection related discharges 53% were meningococcal meningitis and 55% were meningococcemia. The annual hospitalization rate was 2.33, 1.23 and 1.29 cases per 100,000 for invasive meningococcal disease, meningococcal meningitis and meningococcemia, respectively. 846 deaths for invasive meningococcal disease, 235 for meningococcal meningitis and 605 for meningococcemia were reported. Although an important decrease in meningococcal infections related morbidity and mortality has occurred in the last twelve years in Spain, they still continue being major causes of hospitalization and death, especially in the children up to 2 years of age. Future preventive measures, such as vaccination with vaccines covering new conjugated serogroups (B and ACYW135), could further improve population health.

Epidemiology of syphilis-related hospitalisations in Spain between 1997 and 2006: a retrospective study.

Objective In order to illustrate the important public health impact of syphilis, which is a preventable infection, the epidemiology of syphilis-related hospitalisations in Spain was studied over a 10-year period. Methods A retrospective study was conducted using the National Epidemiological Surveillance System for Hospital Data (Minimum Data Set). All hospitalisations due to syphilis infection in any diagnostic position (ICD-9-CM 090-097) between 1997 and 2006 were analysed, according to the Spanish version of the International Classification of Diseases, ninth revision (ICD-9-CM). Results There were 9556 hospitalisations associated with syphilis in Spain. The hospitalisation rate was 2.33 per 100 000 population, the mortality rate was 0.07 per 100 000 population and the lethality was 3.17%. The hospitalisation rate increased significantly after 2000 and was higher in men. Conclusion Syphilis remains a major public health problem because of both potential complications and its close association with HIV infection. It is necessary to promote early diagnosis, ensure treatment in patients with syphilis and emphasise health promotion and prevention programmes.

Epidemiología de las hospitalizaciones por tosferina en España (1997-2015) / No disponible

La tosferina ha aumentado su incidencia en los últimos 10 años en países con altas coberturas vacunales. El objetivo del presente trabajo es estudiar la epidemiología de las hospitalizaciones por tosferina, como indicador grave de la enfermedad, en las distintas Comunidades Autónomas y ver su evolución en un periodo de 19 años. Para ello, se analizó retrospectivamente la información recogida en el Conjunto Mínimo Básico de Datos sobre las altas hospitalarias relacionadas con un diagnóstico de tosferina y se calculó la tasa de hospitalización anual, el tiempo de estancia en el hospital y la tasa de letalidad. Se registraron un total de 13.312 hospitalizaciones relacionadas con tos ferina. Más del 91% se produjeron en menores de un año (n = 12.127). La estancia media hospitalaria fue de 7,9 días. La tasa media anual de hospitalización durante el periodo fue de 1,6 hospitalizaciones por 100.000 habitantes y 149, 6 hospitalizaciones por 100,000 niños menores de 1 año. Se produjeron 88 muertes, de las cuales 70 fueron en menores de 4 meses. Las tasas de hospitalización aumentaron de forma significativa durante el periodo en la mayoría de las Comunidades Autónomas. En este estudio todavía no se observan los efectos de las nuevas medidas preventivas que incluyen la vacunación en la mujer embarazada, que deberán ser seguidos con detenimiento en la actual situación epidemiológica

Despite high vaccination coverage, whooping cough has increased its incidence in the last decade. The aim of this study is to analyze the epidemiology of the hospitalizations due to whooping cough as an indicator of severe disease in the different regions of Spain over a period of 19 years. Information on hospital discharges related to a diagnosis of whooping cough from the National System of Hospital Data was retrospectively analyzed. Annual hospitalization rates, case-fatality rates and average length of hospitalization were calculated. A total of 13,312 hospitalizations related to whooping cough were recorded. More than 91% of them occurred in infants up to 12 months of age (n = 12,127). Average length of hospitalization was 7.86 days. Annual hospitalization rate during the period was 1.629 hospitalizations per 100,000 population and 149.601 hospitalizations per 100,000 infants up to 12 months of age. Eighty-eight deaths occurred in the study period, of those 70 were in infants younger than 4 months old. Hospitalization rates significantly increased during the study period in most of the regions. New preventive measures, such as vaccination of pregnant women cannot be evaluated in this study, but epidemiology of whooping cough in this specific group should be monitored in the current epidemiological situation

Efecto de la infección por Clostridium difficile sobre la estancia hospitalaria. Estudio de cohortes / The effect of Clostridium difficile infection on length of hospital stay. A cohort study

Introducción: Clostridium difficile es responsable de un espectro de enfermedades denominado «infección por Clostridium difficile» (ICD). Actualmente es la primera causa de diarrea de origen hospitalario en los países desarrollados. Esta infección se ha visto asociada tanto a un aumento de la estancia hospitalaria y de la mortalidad, como a una mayor probabilidad de reingreso. En nuestro país estos efectos indeseables no han sido aún caracterizados. Nuestro objetivo fue cuantificar el exceso de estancia hospitalaria atribuible a la infección por C. difficile. Métodos Estudio retrospectivo de cohortes emparejadas, por edad, sexo y fecha de ingreso, realizado en un hospital universitario de tercer nivel, en el contexto de un brote de transmisión hospitalaria de ICD. Resultados La cohorte de infectados incluyó a 38 pacientes y la de no infectados, a 76. Los pacientes que sufrieron ICD presentaron mayor desnutrición al ingreso (OR = 10,3; 3,6-29,6), estuvieron expuestos a una mayor variedad de antibióticos (diferencia de medias = 1,5; 0,7-2,2), presentaron una mayor mortalidad (31,6% frente a 6,6% de los controles; p < 0,001) y una mayor estancia hospitalaria (31,5 días de mediana frente a 5,5 días de los controles; p < 0,001). Una vez ajustado el análisis, la infección por C. difficile se asoció a un exceso de estancia de 4 días (p < 0,001).Conclusiones La infección por C. difficile tiene importantes consecuencias sobre el alargamiento de la estancia hospitalaria y, por tanto, sobre los costes sanitarios (AU)

Introduction: Clostridium difficile is responsible for a spectrum of diseases known as “Clostridium difficile infection” (CDI). It is currently the leading cause of nosocomial diarrhea in developed countries. This infection has been associated with both increased hospital stay and mortality, and to a greater likelihood of readmission. In our country these undesirable effects have not yet been characterized. Our objective was to quantify the increase in hospital stay attributable to infection by C. difficile. Methods: A retrospective cohort study matched by age, sex and admission date, was conducted in atertiary care university hospital during an outbreak of nosocomial transmission of CDI. Results: The cohort study included 38 infected, and 76 non-infected patients. Patients who developed CDI showed a higher proportion of malnutrition at admission (OR = 10.3; 3.6 to 29.6), were exposed to a wider range of antibiotics (mean difference = 1.5; 0.7-2.2), had a higher mortality (31.6% vs. 6.6% of controls, P < .001), and a longer hospital stay (median 31.5 days versus 5.5 days for controls, P < .001). After adjustment, infection by C. difficile was associated with an increase in hospital stay of 4 days (P < .001).Conclusions: C. difficile infection has important consequences on the length of hospital stay, and therefore on health costs (AU)

Epidemiología de la gastroenteritis por rotavirus adquirida en la comunidad en el área de Fuenlabrada (Madrid) / Epidemiology of community-acquired rotavirus gastroenteritis in Fuenlabrada (Madrid)

Introducción: Rotavirus es el agente etiológico principal en las formas graves de gastroenteritis aguda (GEA) en la infancia. Material y métodos Estudio prospectivo de la incidencia y coste de GEA adquirida en la comunidad en menores de 5 años. Resultados Rotavirus fue el agente etiológico más frecuente. La incidencia acumulada de hospitalización por esta causa disminuyó a lo largo del periodo del estudio. Conclusiones Rotavirus es la causa más frecuente de GEA adquirida en la comunidad que requiere ingreso hospitalario en el área de Fuenlabrada (Madrid) (AU)

Introduction: Rotavirus is the main aetiological agent of severe acute gastroenteritis in childhood. Material and methods: A prospective study on the incidence and cost of acute gastroenteritis in childrenunder 5 years. Results: Rotavirus was the most frequent aetiological agent. The cumulative incidence of hospitalisation decreased over the study period.Conclusions: Rotavirus is the most common cause of acute community acquired gastroenteritis requiring hospital admission in the area of Fuenlabrada (Madrid) (AU)

Infección de herida quirúrgica en paciente trasplantado / Infection of the surgical wound in a transplanted patient

No disponible